Surgical Device with DC Power Connection

ABSTRACT

A system and method for providing additional power to a hand-held surgical device from a supplemental DC power supply. The hand-held surgical device includes a generator and an internal power supply. The internal power supply is a battery or a capacitor either which can withstand a high-temperature and/or a low-temperature sterilization procedure while within the hand-held surgical device. The supplemental DC power supply can provide alone or in combination with the internal power supply sufficient power to the generator to perform an electrosurgical procedure. The supplemental DC power supply is connected through a detachable cord to the hand-held surgical device. The DC power supply may be outside a sterile surgical environment.

BACKGROUND

1. Technical Field

The present disclosure relates to apparatuses and method for supplyingpower to a handheld surgical device, and more particularly, to asupplementary DC power source to increase the power supplied to agenerator within the handheld surgical device.

2. Background of Related Art

Energy-based tissue treatment is well known in the art. Various types ofenergy (e.g., electrical, ultrasonic, microwave, cryogenic, thermal,laser, etc.) are applied to tissue to achieve a desired result.Electrosurgery involves application of high frequency electrical currentto a surgical site to cut, ablate, coagulate or seal tissue. Inmonopolar electrosurgery, as shown in FIG. 1A, a source or activeelectrode 2 delivers high frequency energy from the electrosurgicalgenerator 20 to the tissue and a return electrode 2 carries the currentback to the generator. In monopolar electrosurgery, the source electrodeis typically part of the surgical instrument held by the surgeon andapplied to the tissue to be treated. A patient return electrode isplaced remotely from the active electrode to carry the current back tothe generator.

In bipolar electrosurgery, as shown in FIG. 1B, one of the electrodes ofthe hand-held instrument functions as the active electrode 14 and theother as the return electrode 16. The return electrode is placed inclose proximity to the active electrode such that an electrical circuitis formed between the two electrodes (e.g., electrosurgical forceps 10).In this manner, the applied electrical current is limited to the bodytissue positioned immediately adjacent to the electrodes. When theelectrodes are sufficiently separated from one another, the electricalcircuit is open and thus inadvertent contact with body tissue witheither of the separated electrodes does not cause current to flow.

Electrosurgical instruments have become widely used by surgeons inrecent years. By and large, most electrosurgical instruments arehand-held instruments, e.g., an electrosurgical pencil, which transferelectrical or electrosurgical energy to a tissue site. As used hereinthe term “electrosurgical pencil” is intended to include instrumentswhich have a handpiece that is attached to an active electrode and whichis used to cauterize, coagulate and/or cut tissue. Typically, theelectrosurgical pencil may be operated by a handswitch or a foot switch.The active electrode is an electrically conducting element that isusually elongated and may be in the form of a thin flat blade with apointed or rounded distal end. Alternatively, the active electrode mayinclude an elongated narrow cylindrical needle that is solid or hollowwith a flat, rounded, pointed or slanted distal end. Typicallyelectrodes of this sort are known in the art as “blade”, “loop” or“snare”, “needle” or “ball” electrodes.

As mentioned above, the handpiece of the electrosurgical pencil isconnected to a suitable electrosurgical energy source (i.e., generator)which produces the electrical energy necessary for the operation of theelectrosurgical pencil. In general, when an operation is performed on apatient with an electrosurgical pencil, electrical energy from theelectrosurgical generator is conducted through the active electrode tothe tissue at the site of the operation and then through the patient toa return electrode. The return electrode is typically placed at aconvenient place on the patient's body and is attached to the generatorby a conductive material.

Some electrosurgical procedures utilize electrosurgical forceps that useboth mechanical clamping action and electrical energy to affecthemostasis by heating tissue and blood vessels to coagulate, cauterizeand/or seal tissue. As an alternative to open forceps for use with opensurgical procedures, many modern surgeons use endoscopes and endoscopicinstruments for remotely accessing organs through smaller, puncture-likeincisions. As a direct result thereof, patients tend to benefit fromless scarring and reduced healing time.

Endoscopic instruments are typically inserted into the patient through acannula, or port, which has been made with a trocar. Typical sizes forcannulas range from three millimeters to twelve millimeters. Smallercannulas are usually preferred, which, as can be appreciated, ultimatelypresents a design challenge to instrument manufacturers who must findways to make endoscopic instruments that fit through the smallercannulas. Such endoscopic instruments may use monopolar forceps, bipolarforceps or a combination monopolar/bipolar forceps.

Some portable battery powered surgical devices are powered bylithium-ion batteries. As these batteries require charging before use, alithium-ion battery requires removal of the battery and sterilization ina hydrogen-peroxide system due to the low heat tolerance of lithium-ionbatteries. Hydrogen-peroxide sterilization systems cost more money thenhigh-temperature sterilization techniques and are not as widelyavailable in all locations.

SUMMARY

In accordance with the present disclosure, a system and method forproviding additional power to a hand-held surgical device from asupplemental DC power supply. The hand-held surgical device includes agenerator and an internal power supply. The internal power supply is abattery or a capacitor either which can withstand a high-temperature orlow temperature sterilization procedure while within the hand-heldsurgical device. The supplemental DC power supply can provide alone orin combination with the internal power supply sufficient power to thegenerator to perform an electrosurgical procedure. The supplemental DCpower supply is connected through a detachable cord to the hand-heldsurgical device. The DC power supply may be outside a sterile surgicalenvironment.

According to an embodiment of the present disclosure, an apparatus forperforming a surgical procedure. The apparatus includes a hand-heldsurgical device having a generator and an internal power supply. Theentire hand-held surgical device can withstand at least one type ofhigh-temperature sterilization. The apparatus further includes asupplemental DC power supply in external communication with the internalpower supply and a cord that connects the supplemental DC power supplyto the hand-held internal power supply to increase the power supplied tothe generator.

According to another embodiment of the present disclosure, an apparatusfor performing a surgical procedure. The apparatus includes a hand-heldsurgical device having a generator and an internal battery. The internalbattery while within the hand-held surgical device can withstand atleast one type of high-temperature sterilization. The apparatus furtherincludes a supplemental DC power supply in external communication withthe internal battery and a cord that connects the supplemental DC powersupply to the internal battery to increase the power supplied to thegenerator.

According to another embodiment of the present disclosure, a method forperforming a surgical procedure includes the step of connecting ahand-held surgical device to a supplemental DC power supply. Thehand-held surgical device includes an internal power supply and agenerator within. The method further includes the steps of performing asurgical procedure and selectively augmenting power supplied to thegenerator via the internal power supply using the supplemental DC powersupply. Alternatively, the supplemental DC power supply can directlysupply power to the generator and the internal power supply canselectively augment power supplied to the generator, such as during peakusage requirements. The method also includes the steps of disconnectingthe hand-held surgical device from the supplemental DC power supply andperforming a high-temperature sterilization procedure on the hand-heldsurgical device including the internal power supply.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects, features, and advantages of the presentdisclosure will become more apparent in light of the following detaileddescription when taken in conjunction with the accompanying drawings inwhich:

FIGS. 1A-1B are schematic diagrams of electrosurgical systems;

FIG. 2 is a side, perspective view of a handheld surgical instrumentaccording to an embodiment of the present disclosure;

FIG. 3 is a side, perspective view of a handheld surgical instrumentaccording to an alternative embodiment of the present disclosure;

FIG. 4 is a perspective view of an electrosurgical pencil in accordancewith an embodiment of the present disclosure;

FIG. 5 is a partially broken away, side elevational view of theelectrosurgical pencil of FIG. 4;

FIG. 6 is a partially broken away, side elevational view of analternative embodiment of the electrosurgical pencil of FIG. 4;

FIG. 7A is a perspective view of an endoscopic forceps and generatoraccording to the present disclosure;

FIG. 7B is interior perspective view of the endoscopic forceps of FIG.7A according to the present disclosure;

FIG. 7C is interior perspective view of the endoscopic forceps of FIG.7A according to an alternative embodiment of the present disclosure; and

FIG. 8 is a flow chart using a supplementary power supply with asurgical device according to the present disclosure.

DETAILED DESCRIPTION

Particular embodiments of the present disclosure are describedhereinbelow with reference to the accompanying drawings; however, it isto be understood that the disclosed embodiments are merely exemplary ofthe disclosure and may be embodied in various forms. Well-knownfunctions or constructions are not described in detail to avoidobscuring the present disclosure in unnecessary detail. Therefore,specific structural and functional details disclosed herein are not tobe interpreted as limiting, but merely as a basis for the claims and asa representative basis for teaching one skilled in the art to variouslyemploy the present disclosure in virtually any appropriately detailedstructure.

Like reference numerals may refer to similar or identical elementsthroughout the description of the figures. As shown in the drawings anddescribed throughout the following description, as is traditional whenreferring to relative positioning on a surgical instrument, the term“proximal” refers to the end of the apparatus which is closer to theuser and the term “distal” refers to the end of the apparatus which isfurther away from the user.

Electromagnetic energy is generally classified by increasing energy ordecreasing wavelength into radio waves, microwaves, infrared, visiblelight, ultraviolet, X-rays and gamma-rays. As used herein, the term“microwave” generally refers to electromagnetic waves in the frequencyrange of 300 megahertz (MHz) (3×10⁸ cycles/second) to 300 gigahertz(GHz) (3×10¹¹ cycles/second). As used herein, the term “RF” generallyrefers to electromagnetic waves having a lower frequency thanmicrowaves. Ultrasonic generally refers to electromagnetic waves in thefrequency range of 1 kHz to 2000 kHz.

With reference to FIGS. 2-3, and initially with reference to FIG. 2, ahandheld surgical instrument 50 configured for use with a removablesupplementary DC power supply 134 according to an embodiment of thepresent disclosure is illustrated. The handheld surgical instrument 50may be configured for use as, but not limited to, electrosurgicalforceps, electrosurgical staplers, etc. For illustrative purposes, FIGS.2-3 disclose a handheld ultrasonic surgical instrument 50 (instrument50).

Instrument 50 includes a housing 46 configured to house one or morecomponents, e.g., transducer, waveguide and electrical circuitry that isconfigured for electrical communication with a battery “B” or acapacitor 150 and the supplementary DC power supply 134 of theinstrument 50. A proximal end 51 of housing 46 is configured to coupleto an ultrasonic generator 28 (generator 28) and the battery “B” orcapacitor 150 (see FIG. 3), described in greater detail below. A distalend 53 of the housing 46 is configured to support and/or couple to ashaft 42.

Shaft 42 extends from housing 46 and defines a longitudinal axis “A-A”therethrough. Shaft 42 includes a length that ranges from about 20 cm toabout 40 cm. In the illustrated embodiment, shaft 42 includes a lengththat is 39 cm. A shaft rotation knob 26 is operably coupled to the shaft42 and is configured to rotate the shaft 42 approximately 360° in eitherdirection about the longitudinal axis “A-A.” A proximal end 48 of theshaft 42 is operably coupled to the housing 46 and a distal end 12 ofthe shaft 42 is operably coupled to an end effector 38. The operation ofparts of the end effector 38 (e.g., jaw members 16 and 18) are movablerelative to one another upon actuation of handle assembly 20 coupled tohousing 46 as described in more detail below.

More particularly, handle assembly 20 includes a moveable handle 52 anda fixed handle 44. Jaw member 40 is pivotable about jaw member 18(and/or the distal end 12 of the shaft 42) when lever or movable handle52 of handle assembly 20 is moved proximally. Jaw member 40 is movablefrom an open position for positioning tissue between the jaw members 40and 18, to a clamping position for grasping tissue between the jawmembers 40 and 18 and against jaw member 18. Jaw member 18 serves as anactive or oscillating blade and is configured to effect tissue. To thisend, jaw member 18 includes an ultrasonic member (not shown) that isoperably coupled to a transducer 32 (shown in phantom), and an operatingsurface 22 configured to effect tissue. In the illustrated embodiment,the operating surface 22 is configured to transect, dissect and/orcoagulate tissue upon actuation of an activation button 24 operablycoupled to generator 28.

Activation button 24 places the instrument 50 in two modes of operation,a low-power mode of operation and a high-power mode of operation. Moreparticularly, activation button 24 is depressable to a first positionfor delivering low-power to the active jaw member 18 and a secondposition for delivering high-power to the active jaw member 18. In thefirst position, one or more audio or visual indicators may indicate touser that the activation button 24 is in the low-power mode. Forexample, and in one particular embodiment, an audio indicator mayinclude a low-pitch, slow pulsating tone that indicates to a user thatthe activation button 24 is in the first position or low power mode.Likewise, one or more audio or visual indicators (nor shown) mayindicate to user that the activation button is in the high-power mode,e.g., an audio indicator may include a high-pitch, fast pulsating tonethat indicates to a user that the activation button 24 is in the secondposition or high power mode.

Generator 28 is configured to convert electrical energy generated by abattery “B” (FIG. 2) or capacitor 150 (FIG. 3) and supplementary DCpower supply 134 to ultrasonic energy to drive the active jaw member 18.

The electrochemistry of battery “B” may be Nickel Cadmium (NiCad),Nickel Metal-Hydride (NiMH), or other type of battery electrochemistrythat can withstand high-temperature sterilization cycles. Both NiCad andNiMH batteries can withstand the high temperatures of sterilization withthe appropriate temperature buffering in the mechanical design of thehousing 46. Additionally, both NiCad and NiMH batteries can withstandleast one type of low temperature of sterilization procedure Oneadvantage of using battery “B” is that the instrument 50 is moretolerant to power interruptions or heavy usage because battery “B”maintains a charge longer than capacitor 150.

Capacitor 150 may be used to supplement the power supplied to the endeffector 38 during peak requirements. Capacitor 150 may be aconventional capacitor, an ultracapacitor (electric-double layercapacitor), a nanoscale supercapacitor, or other type of knowncapacitor. Ultracapacitors can release energy faster then a battery andhave short re-charging cycles. A nanoscale supercapacitor may be formedfrom a nanopourous anodic aluminum oxide film followed by an atomiclayer deposition of metal, insulator, and metal. Capacitor 150 isconfigured to withstand high and/or low temperature sterilizationprocedures.

Generator 28 operably couples to the housing 46 and may be selectivelyremovable therefrom. More specifically and in one embodiment, to securethe generator 28 to the housing 46, a user positions the generator 28 ona top portion of the housing 46 at a proximal end thereof and turns atorquing knob 36 to hand tighten the generator 28 to the housing 46. Incertain embodiments, a torque wrench (not shown) may be utilized tocontrol rotation of the torquing knob 36.

Generator 28 also includes transducer 32 (shown in phantom) that isconfigured to convert electrical energy to mechanical energy thatproduces motion of a waveguide 34 disposed in operative communicationwith the active jaw member 18. When the transducer 32 and waveguide 34are driven at a specific resonant frequency, they produce mechanicalmotion at the active jaw member 18. The electronics of the generator 28converts the electrical energy from battery “B” or capacitor 150 and thesupplementary DC power supply 134 into a high voltage AC waveform which,in turn, drives the transducer 32. In one particular embodiment, thefrequency of this AC waveform is the same as the resonant frequency ofthe waveguide 34 and transducer 32. As can be appreciated, the magnitudeof the AC waveform includes a value that produces the proper amount ofmechanical motion.

Handle 44 also includes electrical circuitry (not shown (therein that isutilized to provide communication between the generator 28, thecontroller “C”, and the battery “B” or capacitor 150, and thesupplementary DC power supply 134.

The supplementary DC power supply 134 is connected through cable 132which may be detachable from instrument 50 and or the supplementary DCpower supply 134. The supplementary DC power supply 134 may rechargebattery “B” or capacitor 150 when the instrument 50 is idle, e.g., whenpower is not being supplied to active jaw member 18. Additionally, thesupplementary DC power supply 134 may selectively augment the powersupplied from battery “B” or capacitor 150 to generator 28.Alternatively, the supplementary DC power supply 134 may supply powerdirectly to generator 28.

The supplementary DC power supply 134 may also be detachably coupled tothe instrument 50 through cable 132. The supplementary DC power supplymay be an AC to DC converter, a DC to DC converter, DC power source, orother similar power supply. The supplementary power supply 134 may bedisposed outside the sterile surgical environment, and therefore doesnot require sterilization. The AC/DC converter may plug into an outletinside or outside the sterile surgical environment. The DC power sourcecould be a lithium ion battery that is stored outside the sterilesurgical environment, and therefore does not need to be sterilized.Cable 132 is sufficiently long enough to allow the user sufficientmaneuverability and connect to the supplementary DC power source 134that may be inside or outside the sterile surgical environment.Additionally, cable 132 can be permanently attached to the handheldsurgical instrument 50 (FIGS. 2-3), 100 (FIG. 4-6), or 510 (FIGS. 7A-7C)or completely removable from the handheld instrument 50, 100, or 510 toallow replacement or substitution of a differently sized cable. Cable132 can be sterilized with the handheld surgical instrument 50, 100, or510 or separately from the handheld surgical instrument depending on howthe cable 132 is connected. For example, cable 132 is removable from thesupplementary DC power supply 134 to allow sterilization of cable 132without the need to sterilize the supplementary DC power supply 134.

FIGS. 4-5 show an electrosurgical pencil constructed in accordance withan embodiment of the present disclosure and is shown generally as 100.Electrosurgical pencil 100 includes an elongated housing 102 configuredand adapted to support a blade receptacle 104 at a distal end 103thereof which, in turn, receives a replaceable electrocautery endeffector 106 in the form of a loop and/or blade therein. Electrocauteryblade 106 is understood to include a planar blade, a loop, a needle andthe like. A distal end portion 108 of blade 106 extends distally fromreceptacle 104 while a proximal end (not shown) portion of blade 106 isretained within distal end 103 of housing 102. Electrocautery blade 106may be fabricated from a conductive type material, such as, for example,stainless steel, or is coated with an electrically conductive material.The electrosurgical pencil also includes a generator board “G”, acontroller board “C”, and a battery “B” (See FIG. 5).

As shown, electrosurgical pencil 100 is coupled to a return pad “R” viaa cable 112. Cable 112 includes a transmission wire that electricallyinterconnects return pad “R” with a return port 111 defined inelectrosurgical pencil 100 to connect the return pad “R” to thegenerator “G”.

For the purposes herein, the terms “switch” or “switches” includeselectrical actuators, mechanical actuators, electro-mechanical actuators(rotatable actuators, pivotable actuators, toggle-like actuators,buttons, etc.) or optical actuators.

Electrosurgical pencil 100 includes at least one activation button,e.g., three activation buttons 124 a-124 c, each of which is supportedon an outer surface 107 of housing 102. Each activation button 124 a-124c is operatively connected to a respective control switch 126 a-126 cwhich, in turn, regulates the transmission of electrical energy suppliedfrom the electrosurgical generator “G” to electrosurgical blade 106.More particularly, control switches 126 a-126 c are electrically coupledto a control loop 116 and are configured to close and/or completecontrol loop 116, which causes the controller board “C” to send aninstruction to electrosurgical generator “G”. Power is then supplied tothe generator “G” from battery “B” and/or the supplementary DC powersupply 134. The supplementary DC power supply 134 is connected through acable 132 which may be detachable from the surgical device 100 and orthe supplementary DC power supply 134. The supplementary DC power supply134 recharges battery “B” when the surgical device 100 is idle, e.g.,when power is not being supplied to the electrosurgical blade 106. As inFIGS. 2-3, the electrochemistry of battery “B” may be Nickel Cadmium(NiCad), Nickel Metal-Hydride (NiMH), or other type of batteryelectrochemistry that can withstand high-temperature sterilizationcycles with the appropriate temperature buffering in the mechanicaldesign of the housing 102.

Alternatively, as shown in FIG. 6, the power is supplied from acapacitor 150 and/or the supplementary DC power supply 134. Thesupplementary DC power 134 may provide energy for normal continuousoperation and/or supply may be used to maintain and/or recharge thecapacitor 150. Capacitor 150 may be used to supplement the powersupplied to the end effector 106 during peak requirements. As similar toFIG. 3, capacitor 150 may be a conventional capacitor, an ultracapacitor(electric-double layer capacitor), a nanoscale supercapacitor, or othertype of known capacitor.

Electrosurgical pencil 100 further includes one or more intensitycontrollers 128 a and/or 128 b, each of which are slidingly supported inguide channels 130 a, 130 b, respectively, defiend in outer surface 107of housing 102. Each intensity controller 128 a and 128 b is aslide-like potentiometer. Each intensity controller 128 a and 128 b andrespective guide channel 130 a and 130 b may be provided with a seriesof cooperating discreet or detented positions defining a series ofpositions that allow easy selection of output intensity from a minimumamount to a maximum amount. The series of cooperating discreet ordetented positions also provides the surgeon with a degree of tactilefeedback. One of the series of positions for intensity controllers 128a, 128 b may be an “off” position (i.e., no level of electrical or RFenergy is being transmitted).

Intensity controllers 128 a and 128 b are configured and adapted toadjust one of the power parameters (e.g., RF energy field, voltage,power and/or current intensity) and/or the power verses impedance curveshape to affect the perceived output intensity.

As shown in FIGS. 5 and 6, controller board “C” receives inputs from thevarious switches 126 a-126 c and intensity controllers 128 a-128 b thatare disposed in housing 102 and sends a signal to the generator “G” togenerate an energy signal. The energy signal may be RF, ultrasonic, orother signal selected by the user. The generator is powered from thesupplementary DC power supply 134, the battery “B”, and/or the capacitor150.

With reference to FIGS. 7A and 7B, an illustrative embodiment of awireless electrosurgical apparatus, e.g., a bipolar forceps 510 (forceps510) is shown. Forceps 510 includes an electrosurgical generator “G”, abattery “B”, and a supplementary DC power supply 134 for performing anelectrosurgical procedure (See FIG. 7B). The electrosurgical proceduremay include sealing, cutting, cauterizing coagulating, desiccating, andfulgurating tissue all of which may employ RF energy. Theelectrosurgical generator “G” may be configured for monopolar and/orbipolar modes of operation and may include or be in operativecommunication with a system (not shown) that may include one or moreprocessors in operative communication with one or more control modulesthat are executable on the processor. The control module (not explicitlyshown) may be configured to instruct one or more modules to transmitelectrosurgical energy, which may be in the form of a wave orsignal/pulse to the forceps 510.

Forceps 510 is shown configured for use with various electrosurgicalprocedures and generally includes a housing 520, a rotating assembly580, a handle assembly 530, and a trigger assembly 570. The triggerassembly 570 includes a finger actuator 572. For a more detaileddescription of the housing 520, rotating assembly 580, and triggerassembly 570, reference is made to commonly-owned U.S. patentapplication Ser. No. 11/595,194 filed on Nov. 9, 2006, now U.S. PatentPublication No. 2007/0173814.

With continued reference to FIGS. 7A and 7B, forceps 510 includes ashaft 512 that has a distal end 514 configured to mechanically engage anend effector assembly 590 and a proximal end 516 that mechanicallyengages the housing 520.

Handle assembly 530 includes a fixed handle 550 and movable handle 540.Fixed handle 550 is integrally associated with housing 520 and handle540 is movable relative to fixed handle 550 for effecting movement ofone or more components, e.g., a drive wire 533 (shown in phantom in FIG.7B), operably associated with a drive assembly 534 via one or moresuitable mechanical interfaces, e.g., a linkage interface, gearinterface, or combination thereof.

Drive assembly 534 is in operative communication with handle assembly530 (see FIGS. 7A and 7B) for imparting movement of one or both jawmembers 525, 535 of end effector assembly 590. The drive assembly 534may include a compression spring 547 that cooperates with drive wire 533to facilitate closing the jaw members 525 and 535 with uniform andconsistent pressure. Drive wire 533 is configured such that proximalmovement thereof causes the movable jaw members 535 and 545 andoperative components associated therewith, e.g., seal plate 528 and 535,to pivot relative to one another about pivot 511 to approximate tissue.With this purpose in mind, drive rod or wire 533 may be made from anysuitable material and is proportioned to translate within the shaft 512.In the illustrated embodiments, drive wire 533 extends through the shaft512.

RF energy is supplied from the generator “G” when a user presses switch560 via controller “C”. The power to generate the RF energy signal issupplied from battery “B” and or the supplementary DC power supply 134.The electrochemistry of battery “B” may be Nickel Cadmium (NiCad),Nickel Metal-Hydride (NiMH), or other type of battery electrochemistrythat can withstand high-temperature sterilization cycles. Further thesupplementary DC supply 134 may be an AC/DC converter, DC/DC converter,a large lithium ion battery, or other similar power supply. The cable132 connecting the supplemental DC power supply 134 is similar to theone used with the ultrasonic instrument 50, however when used with a RFgenerator “G”, the peak power needs are greater and therefore the cable132 is larger. Also, the larger cable 132 would need a lower inductanceimpedance to maintain stable power during transient loading conditions.Alternatively, as shown in FIG. 7C, battery “B” may be replaced with acapacitor 150. Capacitor 150 may be a conventional capacitor, anultracapacitor (electric-double layer capacitor), a nanoscalesupercapacitor, or other type of known capacitor.

FIG. 8 is a flow diagram of process 600 for operating a surgical device,such as instrument 50, 100 or 510, using a supplementary DC power supply134. The process 600 starts at step 605, and with an operator connectinga surgical instrument 50, 100, or 510 to the supplemental DC powersupply 134 at step 610. Next at step 620, an operator selects anoperating mode by pressing an activation button or switch, such as 52,124 a-124 c or 560, on the handheld device 50, 100, or 510 respectively.The surgeon then performs the surgical procedure at step 630, which caninclude applying electrical energy at different rates and for differentlengths of time. It also may include the use of one or more instrumentsthat may or may not be powered. If multiple powered instruments areused, the user can use multiple supplemental DC power supplies 134 ordisconnect cable 132 from the instrument 50, 100, or 510, and connectthe new instrument. After the surgical procedure is complete, the userdisconnects the supplemental DC power supply 134 from cable 132 at step640. Cable 132 can be disconnected from the instrument 50, 100, or 510to be sterilized at step 650. The process 600 ends at step 660 after theinstrument 50, 100, or 510 and or cable 132 is sterilized using a hightemperature sterilization method at step 650.

The supplementary DC power supply 134 is used to selectively augment theinternal power supply, which may be battery “B” or capacitor 150. Thepower is then supplied to generator 28 or “G”. During periods wheninstrument 50, 100, or 510 is idle, the supplementary DC power supplymay recharge battery “B” or capacitor 150. Alternatively, thesupplementary DC power supply 134 may supply power directly to generator28 or “G”. Additionally, the internal power supply, which may be battery“B” or capacitor 150, can withstand at least one type of hightemperature sterilization while within the instrument. This allows forreduced costs of sterilization because lithium-ion batteries have lowheat tolerance and require a hydrogen-peroxide system for sterilizationwhich is more expensive then high temperature sterilization methods.

While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of particular embodiments. Those skilled in the artwill envision other modifications within the scope and spirit of theclaims appended hereto.

1. An apparatus for performing a surgical procedure, comprising: ahand-held surgical device having a generator and an internal powersupply, wherein the entire hand-held surgical device can withstand atleast one type of high-temperature sterilization; a supplemental DCpower supply in external communication with the internal power supply;and a cord that connects the supplemental DC power supply to theinternal power supply to increase the power supplied to the generator.2. The apparatus of claim 1, wherein the cord is selectively removablefrom the supplemental power supply to allow the cord to be independentlysterilized using at least one type of high-temperature sterilization. 3.The apparatus of claim 1, wherein the cord is removable from thehand-hand surgical device.
 4. The apparatus of claim 1, wherein theinternal power supply is a battery or a capacitor.
 5. The apparatus ofclaim 4, wherein the capacitor is a super capacitor or a nano supercapacitor.
 6. The apparatus of claim 1, wherein the supplemental DCpower supply is a lithium ion battery, a DC/DC converter, an AC/ACconverter, or an AC/DC converter.
 7. The apparatus of claim 1, whereinthe supplemental DC power supply is located outside of a sterilizedsurgical area and does not require sterilization.
 8. The apparatus ofclaim 1, wherein the supplemental DC power supply recharges the internalpower supply.
 9. The apparatus of claim 1, wherein the supplemental DCpower supply selectively augments power to the generator.
 10. Theapparatus of claim 1, wherein the supplemental DC power supply and theinternal power supply provide the power to the generator in combination.11. The apparatus of claim 1, wherein the generator provides ultrasonicenergy to a transducer that produces motion at a waveguide to effecttissue.
 12. The apparatus of claim 1, wherein the generator providesradio frequency energy signal to an end effector.
 13. The apparatus ofclaim 1, further comprising a controller, wherein the controllerreceives an instruction from a switch, a knob, or a lever relative to anoperating mode and the controller sends the appropriate instruction tothe generator to generate the corresponding energy signal.
 14. Anapparatus for performing a surgical procedure, comprising: a hand-heldsurgical device having a generator and an internal battery, wherein theinternal battery while within the hand-held surgical device canwithstand at least one type of high-temperature sterilization; asupplemental DC power supply in external communication with the internalbattery; and a cord that connects the supplemental DC power supply tothe internal battery to increase the power supplied to the generator.15. The apparatus of claim 14, wherein the battery is a nickel cadmiumor nickel metal-hydride battery.
 16. The apparatus of claim 14, whereinthe supplemental DC power supply is located within a sterilized surgicalarea.
 17. The apparatus of claim 14, wherein the supplemental DC powersupply is located outside a sterilized surgical area.
 18. The apparatusof claim 12, wherein the supplemental DC power supply and the batteryprovide the power to the generator in combination.
 19. A method forperforming a surgical procedure, comprising: connecting a hand-heldsurgical device to a supplemental DC power supply, wherein the hand-heldsurgical device includes an internal power supply and a generatorwithin; performing a surgical procedure; selectively augmenting powersupplied to the generator via the internal power supply using thesupplemental DC power supply; disconnecting the hand-held surgicaldevice from the supplemental DC power supply; and performing ahigh-temperature sterilization procedure on the hand-held surgicaldevice including the internal power supply.
 20. The method of claim 19,further comprises: supplying power directly to the generator from thesupplementary DC power supply.